Attachment_5_-_Release_of_Claims.pdf

PDF 25 KB Posted

Attached to
Renovation of Laboratory Space at Upper Midwest En
Solicitation number
140G0222R0002
Issued by

About this file

This document is a release of claims form to be signed by a contractor upon completion of work under contract number 140G0222R0002 between the contractor and the United States Department of the Interior for renovation of laboratory space at the Upper Midwest Environmental Sciences Center in La Crosse, Wisconsin. By signing the form, the contractor remises, releases and discharges the United States, its officers, agents and employees from all debts, obligations, accounts, claims and demands whatsoever arising under or by virtue of the said contract, with the exception of any items explicitly listed by the contractor.

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Text version

DI-137

(Rev. 8/96)

UNITED STATES

DEPARTMENT OF THE INTERIOR

RELEASE OF CLAIMS

Contract Number

Date

WHEREAS, by the terms of the above contract for

, entered into by the United States of America, hereinafter referred to as the United

States, and the contractor

, it is provided that after completion of all work, and prior to final payment, the contractor will furnish the United States with a release of all claims;

NOW, THEREFORE, in consideration of the above premises and the payment by the United States to the contractor of the amount now due under the contract, to wit, the sum of dollars ($ ), the contractor hereby remises, releases and forever discharges the United States, its officers, agents and employees, of and from all manner of debts, dues, and liabilities, obligations, accounts, claims, and demands whatsoever, in law and in equity, under or by virtue of the said contract, except:

IN WITNESS WHEREOF, the contractor has executed this release this day of , 20 .

__________________________________________________ By ________________________________________________________

(Contractor) (Signature)

Corporation Joint Venture

Partnership Individual ______________________________________________________

(Name)

(Street Number or R.F.D) (Title)

(City) (State) (Zip Code)

COMPLETE ONLY IF CONTRACTOR IS A CORPORATION

I, _________________________________________________, CERTIFY That I am the __________________________________________ of the corporation named as contractor herein; that ____________________________________________________________________, who signed this release on behalf of the corporation, was then _____________________________________________ of said corporation; and that said release was duly signed for and on behalf of said corporation by authority of its governing body.

[SEAL] ___________________________________________________________

(Signature)

File details come from the government source that posted it. Updated .